非穿透性小梁手术联合丝裂霉素C治疗原发性开角型青光眼  

Non-perforating trabecular surgery with mitomycin C in primery open-angle glaucoma

作　　者：种 平[1] 董仰增[1] 李润婷[1] 庞辰久[1] 

机构地区：[1]河南省眼科研究所,郑州450003

出　　处：《眼科研究》2002年第4期351-353,共3页Chinese Ophthalmic Research

摘　　要：目的 评价非穿透性小梁手术联合丝裂霉素C治疗原发性开角型青光眼的临床效果。方法28例39眼原发性开角型青光眼,行非穿透性小梁手术联合术中应用丝裂霉素C。术后观察前房、滤过泡、眼内反应、眼压及视力等情况。随访6～12个月。结果 眼压:术后5～7天7眼在3.96～7.10mmHg,其余太低测不出;术后1、3、6和12个月平均服压分别为（12.34±3.81）、（14.68±3.73）、（15.75±4.14）和（17.13±6.15）mmHg,与术前相比差异有非常显著性（t值分别为16.08、14.89、13.83和10.24,P均<0.01）。随访期间6眼眼压>21mmHg,经术区激光周边虹膜成型或房角穿刺4眼恢复正常。术后早期全部可见滤过泡隆起,随访末期77.1％可见功能性滤过泡。并发症有小梁-后弹力膜穿孔、术区虹膜前粘连及小梁-后弹力膜纤维增生增厚。术后视力与术前相比均有不同程度改善。结论 非穿透性小梁手术联合丝裂霉素C治疗开角型青光眼降眼压效果好,并发症少,是一种理想的手术方法。Objective To evaluate the elinicl effect of non-perforating trabecular surgery( NPTS) with mitomycin C(MMC) in primery open-angle glaucoma( POAG). Methods NPTS with MMC was performed on 39 eyes of 28 patients with POAG. Postoperalively,IOP, intraocular reaction, bleb appearance, complications and visual actuity were observed. The follow-up period ranged from 6 to 12 months. Results The IOP in 7 eyes ranged from 3. 96 to 7. 10 mmHg,and in the others were too low to detect at 5 to 7 days after surgery. The mean postoperative IOP was 12. 43 ±3. 81 mmHg at month 1 ,14. 68 ± 3. 73 mmHg at month 3 ,15. 75 ±4. 14mmHg at month 6 and 17. 13 ±6. 15 mmHg at month 12. There was a statistically significant defference between mean preoperative IOP(44. 53 ± 11. 15 mmHg) and postoperative IOP ( t = 16.08,14.89,13.83 and 10. 24, respectively, P <0.001 ). During the follow-up, the IOP in 6 eyes was > 21 mmHg, and 4 of them returned to normal by laser peripheral iridoplasty and goniopuncture. At early period after surgery, obvious diffuse blebs were seen in all eyes and at the last visit, 77. 1% of eyes had functional blebs. Complications included perforation of trabecular-Descemets membrane,peripheral iris anterior synechia and fibrosis of trabecular-Descemets membrane. The visual acuities of all eyes were improved to different degree. Conclusion NPTS with MMC is a safe and effective anti-glaucoma surgery for POAG.

关 键 词：非穿透性小梁手术 丝裂霉素C 开角型青光眼 综合治疗 

分 类 号：R779.6[医药卫生—眼科]